Submission for the Queensland Government Parliamentary Inquiry into personal health promotion interventions using telephone and web-based technologies

Telephone and web-based technologies such as SMS, smartphone apps, gamification, online/mobile games, online quizzes and tools can be used in personal health interventions in two ways: health promotion or social marketing. In response to the Queensland government's call for submissions to the parliamentary inquiry, a social marketing and design submission from four of the faculties at Queensland University of Technology was submitted. There appears to be a great deal of confusion in government circles about the terms ‘social marketing’ and ‘health promotion’ and often they are used interchangeably when they are actually significantly different approaches. Social marketing is the science and practice of behaviour change and involves goods and services that offer a value proposition, and which incentivises citizens to change their behaviour voluntarily. However, social marketing is often mistakenly used to describe advertising and communication or social media marketing. This submission contains an overview of how technology interventions need to be implemented to be successful, provides examples of the evidence that telephone and web-based interventions can effectively influence public health outcome. This submission poses seven critical factors.

A workplace-based Participatory Action Research project to investigate the effectiveness of nutrition and physical activity interventions for truck drivers in six Queensland transport industry workplaces: 2012-2015

The Queensland Transport Industry Workplace Health Intervention project was a Participatory Action Research (PAR) project to investigate the effectiveness of workplace-based nutrition and physical activity health promotion interventions for truck drivers in transport industry workplaces in south-east Queensland. The project was conducted by a research team at the Queensland University of Technology (QUT), and was funded by the Queensland Government under the Healthier.Happier.Workplaces initiative.

[await full-text]Evaluation of QAS Workplace Health and Safety Action Plan

This report identifies the outcomes of a program evaluation of the five year Workplace Health and Safety Strategy (2012-2017), specifically, the engagement component within the Queensland Ambulance Service. As part of the former Department of Community Safety, their objective was to work towards harmonising the occupational health and safety policies and process to improve the workplace culture. The report examines and assess the process paths and resource inputs into the strategy, provides feedback on progress to achieving identified goals as well as identify opportunities for improvements and barriers to progress. Consultations were held with key stakeholders within QAS and focus groups were facilitated with managers and health and safety representatives of each Local Area Service Network.

Population health planning and health promotion: Opportunities and challenges to improve social determinants

Complex social factors and health issues challenge equitable health outcomes for many people, in particular those living in marginalised communities. Primary health care promises solutions through population health and health promotion approaches to improve social conditions (determinants) affecting health with emphasis on change at systems levels. Yet short-term efficiency focus policy decisions without long-term planning can undermine the effectiveness of primary health care. The workshop goal is to explore opportunities and share ideas about population health planning in Primary Health Networks and other community health care settings, so as to draw out opportunities, challenges and forward thinking health planning and health promotion strategies.

Submission for the Inquiry into the Establishment of a Queensland Health Promotion Commission

This submission outlines eight evidence-based recommendations for consideration by the inquiry committee to achieve the goal of improved and sustained health and wellbeing among Queenslanders. For the Queensland Government to be effective in establishing a commission to improve and sustain health and wellbeing, we recommend the eight actions.

"We don't tell people what to do": An ethnography of health promotion with Indigenous Australians in South East Queensland

This thesis contributes to the decolonisation of health promotion by examining Indigenous-led health promotion practice in an urban setting. Using critical ethnography, the study revealed dialogical, identity-based approaches that centred relationship, community control and choice. Based on the findings, the thesis proposes four interrelated principles for decolonising health promotion and argues that Indigenous-led health promotion presents a way to bridge the rhetoric and practice of empowerment in Australian mainstream health promotion practice.

“We don’t tell people what to do”: Ethical practice and Indigenous health promotion

Health promotion aspires to work in empowering, participatory ways, with the goal of supporting people to increase control over their health. However, buried in this goal is an ethical tension: while increasing people’s autonomy, health promotion also imposes a particular, health promotion-sanctioned version of what is good. This tension positions practitioners precariously, where the ethos of empowerment risks increasing health promotion’s paternalistic control over people, rather than people’s control over their own health. Here in we argue that this ethical tension is amplified in Indigenous Australia, where colonial processes of control over Indigenous lands, lives and cultures are indistinguishable from contemporary health promotion ‘interventions’. Moreover, the potential stigmatisation produced in any paternalistic acts ‘done for their own good’ cannot be assumed to have evaporated within the self-proclaimed ‘empowering’ narratives of health promotion. This issue’s guest editor’s call for health promotion to engage ‘with politics and with philosophical ideas about the state and the citizen’ is particularly relevant in an Indigenous Australian context. Indigenous Australians continue to experience health promotion as a moral project of control through intervention, which contradicts health promotion’s central goal of empowerment. Therefore, Indigenous health promotion is an invaluable site for discussion and analysis of health promotion’s broader ethical tensions. Given the persistent and alarming Indigenous health inequalities, this paper calls for systematic ethical reflection in order to redress health promotion’s general failure to reduce health inequalities experienced by Indigenous Australians.

Brace yourself for a fatter, unhealthier Queensland after health promotion cuts

Queensland appears intent on dismantling its public and preventive health services. Health Minister Lawrence Springborg last week outlined the rationale for getting rid of more than 150 jobs in nutrition, health promotion and Indigenous health, arguing previous “campaigns” and “messaging” around obesity were “piecemeal” and had “grossly failed”. The plan now, the minister argued, is to focus on a new centrally-driven and high-profile approach...

Diet and physical activity behaviour in nurses: A qualitative study

Issue addressed: Previous research has shown that approximately 60% of nurses in Australia are overweight or obese, insufficiently active and have an unhealthy diet. The aim of this study was to gain an understanding of nurses’ determinants contributing to these behaviours. This will inform a needs assessment for a future workplace health promotion program (WHPP) in this group. Methods: Four focus group discussions (n = 17) were conducted with a convenience sample of nurses aged 25–59 years from three hospitals in the Brisbane metropolitan area. Questions addressed barriers and motivation towards diet and physical activity (PA), and suggestions for future WHPP. Data were analysed with Nvivo10 following a thematic analysis with a realistic approach using Self-determination theory as a framework. Results: Work environment was the main barrier for healthy diet behaviours. Long working hours and lack of breaks challenged nurses’ self-control and self-regulation when making dietary choices. Fatigue was the main barrier for PA. However, relaxation, feeling energised before work and better sleep after working night shifts motivated nurses to do PA. Social environment at work seemed to be an effective external motivation to encourage healthy diet and regular PA. Goal-setting, self-monitoring and social support at work were identified as potential WHHP strategies. Conclusion: The workplace and job demands negatively impacts nurses’ lifestyle behaviours. Future interventions should include social support from colleagues, which could motivate nurses to make healthier food choices at work and be more active outside work.

Fa'afaletui : a framework for the promotion of kidney health in an Australian Samoan community

Purpose Samoan communities in Australia exhibit a disproportionate rate of kidney disease compared with other Australians. This article describes a research project that used a culturally sensitive framework, Fa’afaletui, to help reduce the barriers of language and culture and increase our understanding of the factors contributing to kidney disease, in one Samoan community in Australia. Design Semistructured group interviews were undertaken with Samoan community families and groups. The interviews were analyzed according to key concepts embedded in the Fa’afaletui framework. Findings Four factors associated with health risks in this Samoan community emerged—diet and exercise; issues related to the collective (incorporating the village, church, and family); tapu or cultural protocols; and the importance of language. Conclusions The findings suggest that future kidney health promotion initiatives within this Samoan community will be more effective if they are sensitive to Samoan cultural norms, language, and context.

Occupational health nurses’ roles, credentials, and continuing education in Ontario, Canada

The role of the occupational health nurse is broad and includes health care provider, manager/coordinator, educator/advisor, and case manager and consultant, depending on the type of industry and the country in which the nurse practices. Regardless of the type of role, the occupational health nurse must participate in continuing nursing education (CNE) activities. This study describes the roles, credentials, and number of CNE activities undertaken by occupational health nurses working in Ontario, Canada. Using a non-experimental descriptive design, a questionnaire was mailed to all practicing occupational health nurses who are members (n = 900) of a local nursing association. Three hundred fifty-four questionnaires were returned. Nurses reported a variety of roles in the following categories: case management, health promotion, policy development, infection control/travel health, ergonomics, education, research, health and safety, direct care, consultation, disaster preparedness, and industrial hygiene. Sixty-five percent of nurses held an occupational health nurse credential, and 19% of nurses attended more than 100 hours of CNE annually. Occupational health nurses have multiple workplace roles. Many attend CNE activities and they often prepare for credentialing.

Effective health communication in the mining industry

Historically, occupational health and safety has primarily presented as attempts to create a safer work environment for employees. The mining industry carries health and safety risks, often greater than other occupations. Whilst the mining industry is regulated by stringent workplace health and safety regulations, the very nature of the work and environmental influences expose employees to a greater number of injury risk factors than many other industries. The application of risk management techniques has resulted in a substantial decline in injury rates observed for mining operations in developed countries (Donoghue, 2004). This essential focus can be complemented by a more comprehensive approach to occupational health and safety that also supports the design and delivery of proactive health promotion programs...

Understanding body image disturbance in the promotion of mental health : a discourse analytic study

Health care interventions in the area of body image disturbance and eating disorders largely involve individual treatment approaches, while prevention and health promotion are relatively underexplored. A review of health promotion activities in the area of body image in Australia revealed three programmes, the most extensive and longest standing having been established in 1992. The aims of this programme are to reduce body image dissatisfaction and inappropriate eating behaviour, especially among women. Because health promotion is concerned with the social aspects of health, it was hypothesized by the authors that a social understanding of body image and eating disorders might be advanced in a health promotion setting and reflected in the approach to practice. In order to examine approaches to body image in health promotion, 10 health professionals responsible for the design and management of this programme participated in a series of semi-structured interviews between 1997 and 2000. Three discursive themes were evident in health workers' explanations of body image problems: (1) cognitive-behavioural themes; (2) gender themes; and (3) socio-cultural themes. While body image problems were constructed as psychological problems that are particularly experienced by women, their origins were largely conceived to be socio-cultural. The implications of these constructions are critically discussed in terms of the approach to health promotion used in this programme.

Intervening to reduce workplace sitting time : how and when do changes to sitting time occur?

Objective To investigate how and when changes in workplace sitting time occurred following a workplace intervention to inform evaluation of intervention success. Method The 4-week Stand Up Comcare study (June–September 2011) aimed to reduce workplace sitting time via regularly interrupting and replacing sitting time throughout the day. Activity monitor (activPAL3) workplace data from control (n=22) and intervention participants (n=21) were analysed. Differences in the number and usual duration of sitting bouts were used to evaluate how change occurred. To examine when change occurred, intervention effects were compared by hour since starting work and hour of the workday. Change in workplace activity (sitting, standing, stepping) was examined to further inform alignment with intervention messages. Individual variability was examined in how and when the change occurred. Results Overall, behavioural changes aligned with intervention aims. All intervention participants reduced total workplace sitting time, though there was wide individual variability observed (range −29 to −262 min per 8 h workday). On average, intervention participants reduced number of sitting bouts (−4.6 bouts (95% CI −10.1 to 1.0), p=0.106) and usual sitting bout duration (−5.6 min (95% CI −9.8 to −1.4, p=0.011)) relative to controls. Sitting time reductions were observed across the workday, though intervention effects varied by hour of the day (p=0.015). The intervention group successfully adopted the Stand Up and Sit Less intervention messages across the day. Conclusion These analyses confirmed that this workplace intervention successfully modified sitting behaviour as intended (ie, fewer and shorter sitting bouts, with changes occurring throughout the day).